Pharmaceutical companies must be having a field day. A recent study conducted at the University of Pennsylvania found no support for the belief that ADHD medication like Ritalin and Adderall increased the risk of cardiovascular complications among patients. After reviewing the records of more than 241,000 children and adolescents on the drugs from five different states, Dr. Sean Hennessy and his team of researchers concluded that taking medication for ADHD did not increase the chance of heart disease or cardiac arrest among younger folk. In other words, this study effectively declared ADHD as safe for children.  But is it really as harmless as the study claims?

Many experts, including myself, remain skeptical about Dr. Hennessy’s findings. In the scope of pharmacological studies, Dr. Hennessy’s research is considered very small, and the findings may not be scientifically significant as a result. The study also does not encompass the long-term effects of drug use, as it used records from as late as 2007 for its data.

As I’ve pointed out in the past, Ritalin, Adderall and other similar drugs have consistently been found to increase blood pressure in patients taking them, as well as raise the patients’ heart rate. Both side effects could potentially lead to more harmful complications in the cardiovascular systems of those who take the medication. It is possible that early exposure to these conditions, as is the case when children take anti-ADHD medication, can significantly increase the odds of heart problems developing over time. As a result, further research is needed to confirm whether or not using these drugs will raise the chances that patients will suffer heart attacks or cardiovascular disease at an earlier age than the average.

Dr. Steven Nissen of the Cleveland Clinic is one of numerous experts who warn against the study giving parents and pharmacists false reassurance. He argues that any medication that increased both the patient’s heart rate and blood pressure was consistently found to cause long-term cardiovascular damage, and that there is no reason to think popular ADHD medications are any different. Like Dr. Nissen, I advise parents to take Dr. Hennessy’s studies with a grain of salt, and to consider the long-term health of their children before anything else.

Strattera (atomexetine), a drug initially designed to treat depression, is now a popular medication for ADHD and thought to be a safer alternative to Ritalin. Unlike Ritalin, it’s not a stimulant, which means there’s little potential for abuse. It was also thought to be safe and effective for young children, although this has not been studied until recently. A new study published in the journal Pediatrics on March 21 reviewed the use of Strattera on 5- and 6-year olds with ADHD and found mixed results.

The study, which was led by Christopher Kratochvil MD from the University of Nebraska Medical Center, sought to investigate the side effects and efficacy of atomoxetine in young children with ADHD. This double-blind, placebo-controlled, randomized trail involved the participation of 101 children with ADHD aged 5 and 6.  They took their placebo or their atomoxetine for eight weeks, and changes in their behavior were measured using scales.

Although the drug was able to reduce instances of the core symptoms inattention, hyperactivity, and impulsivity, those taking atomoxetine did not show overall functional and clinical improvement.  Many of their symptoms continued to persist despite taking the medication. Side effects of the drug include gastrointestinal problems, poor appetite, and sedation.

The authors gave a contradicting conclusion to their study – they said the medicine was effective, yet significant symptoms remained for most of the children who took atomoxetine.  How can anyone call a treatment “effective” if it failed to alleviate most of the symptoms and problems plaguing these children?

But when it comes to Strattera, its lack of overall efficacy is not the worst part. Strattera has been found to cause liver injury in children, problems passing urine, fainting, stroke, heart attack, and increased blood pressure. Several clinical studies discovered that Strattera increases the risk of suicidal thoughts and behavior among 2,200 children and teenagers with ADHD.

There can be no doubt that Strattera has helped some children and teens manage their ADHD symptoms. But for those who do not benefit from this drug, all they experience are terrible side effects and none of the relief it promises to deliver. In addition, ADHD medications are not designed for long-term recovery; as soon as their effects wear off, the symptoms return.  Studies have also shown that they lose their beneficial effects after three years of use.

Medication might seem like an efficient and simple solution to ADHD, but this complex disorder requires much more than a pill. Instead of medicating your child, consider a holistic treatment program that will get to the root of the symptoms and give you child a proactive role in his or her treatment.

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As students struggled to study for their final exams before the holidays, I noticed that news reports about Adderall use in campus began to appear more frequently. Adderall is a long-acting amphetamine used to treat ADHD, with effects that last up to 10 hours.  It’s ability to boost focus, concentration, memory, and energy levels make it a popular drug among young professionals and college students, who need them to enhance performance. But does Adderall really work for this purpose?

Probably not, says findings from a study done by the University of Pennsylvania.  The paper, which was presented at the Society of Neuroscience’s annual conference last month, discovered that Adderall doesn’t always provide the effects desired by the user.

This study recruited the participation of 47 people, all in their twenties and without an ADHD diagnosis.  Various cognitive functions were tested, from raw intelligence, to memories of specific events, to working memory (the ability to hold information needed for tasks like reasoning and comprehension).  Every subject received a placebo and an Adderall, and they did not know which pill they were taking.

The results were very fascinating to say the least. Previous research has nothing but glowing things to say about Adderall’s effects on cognitive performance; effects include improved focus and alertness, even better judgment.  However, the University of Pennsylvania study reports that while most participants felt the inflated sense of productivity, others did not experience this boost.  In fact, many of the smarter participants showed reduced performance in some cognitive tests.  On the tasks that involved impulsivity and working memory, Adderall leveled the playing field, allowing the below-average performers to perform just as well as the others.

The most interesting finding was the final question they asked the participants – “How and how much did the pill influence your performance on today’s tests?” Those who took Adderall were more likely to say that the pill made them do better on the tests, even though the actual test scores do not reflect an improvement over the placebo score.

It is not known why Adderall benefits some and does not work for others, but the bottom line remains – do not take Adderall, Ritalin, or other ADHD medications unless prescribed by a doctor, especially if you suffer from high blood pressure, mood disorder, or psychosis.

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If ADHD medications like Ritalin are chemically similar to substances like cocaine and amphetamines, does that mean they are addictive? Technically, the answer is no.  Although both Ritalin (methylphenidate) and cocaine stimulate the production of dopamine, Ritalin takes longer to metabolize while cocaine works instantly. For pleasure-seeking recreational users who want the immediate gratification of stimulants, this makes all the difference in the world.  The effects of cocaine wear off faster than Ritalin, causing the user to crave for more drugs to sustain the high. Based on this major difference, experts conclude that ADHD medications metabolize too slowly to be habit-forming – as long as kids and teens take their pills as instructed by their doctor, that is.

But as it turns out, not all teens that use ADHD medications take them as prescribed.  In fact, many of them might not even have ADHD. According to a new study published in the journal Pediatrics, the number of teens who overdosed on ADHD medications rose 76% over the last seven years.

Researchers looked at data gathered by American Association of Poison Control Centers, which was based on calls from 13- to 19-year olds between the years 1998 and 2005. Throughout this time, nationwide calls for ADHD drug misuse increased from 330 to 581 yearly.  Around 42% of affected teens experienced moderate to severe side-effects such as aggression, seizures, personality changes, and psychosis. Most had to be rushed to the hospital for emergency treatment, while four of these cases resulted in death.

Indeed, abuse of Ritalin and other prescription drugs is a phenomenon college guidance counselors struggle with every year.  From the point of view of a teenager, the short-term side effects of ADHD medications are very desirable. Not only does Ritalin suppress appetite and cause weight loss; the drugs help students stay up all night while they frantically finish papers or study for exams. It’s common practice for teens to crush the tablets and snort the medicine as though it were cocaine; this makes the methylphenidate metabolize faster. Unfortunately, ADHD medications do have a strong potential for abuse if they are taken this way.

The study’s authors did not have information as to whether the abusers were diagnosed with ADHD or not. However, anecdotal evidence and previous research suggests that many of these teens did not have ADHD. According to a study by the University of Miami, students who were prescribed ADHD medications were least enthusiastic about taking them. On the other hand, non-prescribed students were more eager to use these drugs, which can be obtained from ADHD peers who are more than happy to sell or trade extra pills. It’s not uncommon for teens without ADHD to fake the symptoms so that they can obtain a prescription from a doctor.

Even though there are only hundreds of overdose cases compared to the millions of children who take Ritalin and other stimulants, the rising numbers are consistent and reflect a major increase in teenage substance abuse problems.  If your child or teen is taking medications for ADHD, make sure that you’re aware of where the pills are stored, how many there are, and who has access to these drugs.  Better yet, keep them in a place where your child can’t sneak them out.  Watch out for signs of abuse, which include difficulty focusing and increased agitation. You may also want to consider trying a non-medical approach to manage ADHD, especially if your child no longer shows improvements after years of taking medication.

Stimulant medications are not the only drugs used to treat ADHD in children.  Over the last several years, doctors have been turning to antidepressant medications like Desipramine and Imipramine for various reasons. Sometimes, these drugs are prescribed because of a co-morbid mood disorder like depression or anxiety.  In other cases, anti-depressants are given when stimulants fail to yield positive results.  Many believe that the increase in the use of anti-depressants for ADHD is a response to popular media’s criticism of stimulant medications and its harmful side effects. But are anti-depressants necessarily more effective and safe than stimulant medications? Can mood disorders and behavioral problems be treated naturally?

The lowdown on anti-depressants

The type of anti-depressants used on children with ADHD is called serotonin reuptake inihibitors (SSRIs). SSRIs promote the circulation of serotonin, the feel-good neurotransmitter, by preventing certain nerve cells from re-absorbing (reuptake) this chemical.   By increasing the level of serotonin in the brain, moods and emotions become more stable. However, because some of the neurotransmitters are contained in neural pathways in other parts of the nervous system, antidepressants can have side effects.  Antidepressants can also interfere with other functions like sleep and appetite.

Research shows that in between 1995 and 1999, the use of Ritalin for children under 7 increased by 23% and the use of SSRIs went up by 580% – even though these drugs were not approved for anyone younger than 18.  Like stimulant drugs, SSRIs contain a lot of harmful side effects.  According to Dr. Ann Blake Tracy, author of the book Prozac: Panacea or Pandora, SSRIs can do more damage than good. The high levels of serotonin caused by these drugs can produce an “initial euphoria, psychosis, mania, aggression, organic brain disease – especially mental retardation at a greater rate in children.”  Ely Lily, the manufacturer of the SSRI Prozac and a number of pharmaceutical drugs, also reports that ADHD patients who take Prozac are twelve times more likely to commit suicide than ADHD patients who are not taking it.  It doesn’t get better when the child stops taking this drug; the withdrawal symptoms of SSRIs usually cause violent side effects.

Drug-free alternatives to SSRIs

Knowing that SSRIs aren’t good is just half the battle. The tricky part is to come up with effective drug-free solutions to the depression, anxiety, and behavioral problems experienced by children with ADHD. The good news is that there are a lot of options – it’s all a matter of finding one that will work best on an individual child.

Children and adults with ADHD have been able to overcome depressive symptoms and mood problems with the right diet. Allergic reactions to certain foods often manifest themselves as bad behavior and mood swings. In fact, you can see this at work through Dr. Doris Rapp’s videos, where she shows how the wrong foods can make a dramatic change in a child’s personality.

The herb St. John’s Wort has not been found to be of any help in treating ADHD symptoms, but studies show that it can alleviate co-morbid depression in individuals from ADHD. Ask your doctor for advice on the right dosage.

Other options that might help include cognitive-behavioral therapy, sports, play therapy, and chiropractic care.

While stimulant medications have helped some children reduce their hyperactivity and inattention, we cannot ignore the fact that a number of children need a more comprehensive treatment for ADHD. Not only do ADHD medications fail to work in the long run, but they also carry serious long-term side effects. Unfortunately, it’s a lot easier to get children and parents to agree to use stimulant drugs. According to a study published in Pediatrics, one in 20 American children received free drug samples from their doctors a year. As for those who decided to take prescription medications that year, almost one in 10 received a free sample. However, the study points out that these free samples may be unsafe.

These conclusions were drawn based on data from 10,295 children and adults in the2004 Medical Expenditure Panel Survey. Four of the fifteen most distributed drug samples were identified by the United States Food and Drug Administration as having serious safety concerns. Among the top four were are Adderall (amphetamine/dextroamphetamine), Strattera (atomoxetine), and Ritalin (methylphenidate) – stimulant medications used to treat ADHD. These stimulants belong to the same drug family as cocaine and pose the same long-term risks as this drug. While they are not addictive by themselves, free samples don’t usually come with clear instructions on how to take them, giving them lots of potential for abuse or recreational use.

Some physicians argue that free drug samples are a cost-effective way to provide medications to those who could not otherwise afford them. However, the study’s findings indicate that most of these free samples never reach their intended market. Only 16% of those who got free samples had no health insurance, and less than a third of these children came from families with low incomes (less than $38,000 a year for a family of four).

Another concern worth noting is that free samples tend to be for new medications that have just been introduced to the market. These new drugs have been released even though their safety profile has yet to be fully studied. And with stimulant ADHD medications, you can’t be too careful about their short-term and long-term side effects.

Treating ADHD with medication seems like the most convenient and practical approach to this disorder and free samples only encourage the casual use of these drugs. But we have to remember that medications alone are not enough to address the full spectrum of ADHD’s causes. In the long run, a comprehensive and holistic approach to ADHD management can circumvent the side effects of stimulants while providing results that last.

There are many effective natural alternative treatments for children with ADHD. Why should you take the risk to have your child experience serious side-effects and unknown long-terms effect.

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